First Do No Harm: Suggestions Regarding Respectful Autism Language

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Dwyer, P., Ryan, J. G., Williams, Z. J., & Gassner, D. L. (2022). First Do No Harm: Suggestions Regarding Respectful Autism Language. Pediatrics, 149(Supplement 4). https://doi.org/10.1542/peds.2020-049437n

Publication date: 1 Apr 2022 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
Publisher source (DOI) OpenAlex source

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Authors

Publication authors
4
Publication authors identified as autistic
4 / 4 (100.0%)
  1. Patrick Dwyer *
  2. Jacalyn G. Ryan *
  3. Zachary J. Williams *
  4. Dena L. Gassner *

Abstract

Nationally and internationally, efforts are ongoing to promote diversity, equity, and inclusion in healthcare and other fields. These efforts require consideration of ways in which language and assumptions impact individuals and communities. The autism and disability spheres are no exception. Indeed, the mental health of autistic people is predicted by the degree to which they feel society accepts them as autistic.1 Thus, we believe discourse that disparages autism could be harmful to autistic people’s well-being. Autistic individuals who face further stigma and discrimination due to other intersectional identities might be particularly vulnerable. Unfortunately, autism research and practice have traditionally used disparaging language grounded in the medical model.Some might object that alternatives to traditional medical model terms are subjective or unscientific. However, we believe traditional terminology is heavily laden with subjective value judgements. For example, the traditional term “disorder” has a decidedly negative connotation. It also implies that individuals’ own characteristics are responsible for their challenges, and it suggests a need to eliminate this disorder. In contrast, the more nuanced word “disability” allows both individual characteristics and societal or contextual barriers to contribute to challenges. The term disability thus appears to be both more scientifically appropriate and less stigmatizing toward a vulnerable population than disorder.In Table 1, we list various traditional terms and concepts that we believe are problematic, along with suggested replacements. We also suggest that practitioners and researchers balance a focus on autistic individuals' challenges with discussion of their strengths and potential. This balanced approach may be especially important for families of young children whose futures may be unclear and a source of considerable anxiety to caregivers.Furthermore, researchers and practitioners should be aware of an ongoing debate between supporters of identity-first (“autistic person”) and person-first (“person with autism”) language. Many autistic individuals support identity-first language2,3 and some fear that person-first language reflects negative attitudes toward autism.4 However, others endorse person-first language.2,3 The term “person on the autism spectrum” is often the most preferred term among autistic individuals and other stakeholder groups,2,3 and this verbiage is typically found to be acceptable by proponents of both person-first and identity-first language. Practitioners should ask about and respect the language preferences of individuals “on the spectrum” who can articulate their views.Overall, in light of concerns that typically-developing people struggle to understand autistic perspectives,5 we urge practitioners and researchers to strive to have empathy for how their language sounds to autistic people. We also suggest it can often be helpful to ask oneself if one would use similar phrasing with other marginalized communities. We feel that there needs to be a shift toward “cultural humility” and willingness to learn from autistic people about autistic identities and how to promote autistic well-being.Practitioners and researchers interested in a more detailed discussion of appropriate autism terminology should refer to Bottema-Beutel and colleagues.6 We provide definitions of neurodiversity terminology (eg, neurodiverse, neurodivergent) in Supplemental Table 2.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 17:07.

Cited references
37
With a DOI
15
Without a DOI, from raw bibliography text
22
9 / 37 (24.3%) cited references include at least one author identified as autistic.
References with data to complete
1 / 37 (2.7%)
References with detected author names
37 / 37 (100.0%)
Without detected author names
0
Without a structured title
1
Without a stable identifier
21
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
104
From DOI or external metadata
104
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
42 / 104 (40.4%) names are linked to an author already present in AutiHub. 62 / 104 (59.6%) names are not yet linked.
Names linked to a person identified as autistic
9 / 104 (8.7%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 9 / 42 (21.4%). Distinct people identified as autistic: 6 / 94 (6.4%).
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